poster 427 predictors of extended inpatient rehabilitation length of stay after traumatic spinal...

Design: Cross-sectional study at a university hospital. Question-naire-assessed physical activity, prosthesis use, quality of life mobil-ity, frustration, social burden, well being. Lower limb amputation 6months before the start of the study. Subjects’ partial foot, Symes,transtibial, transfemoral amputations unilaterally or bilaterally.Quality of life noted high after amputation decrease or stabilize over6 months; physical activity levels, Physical Activity Questionnaire(IPAQ); quality of life World Health Organization Quality of LifeForm (WHO-QOL).Prosthesis-specific quality of life ProsthesisEvaluation Questionnaire (PEQ).Setting: A university hospital.Participants: Diabetic amputees.Interventions: IPAQ, WHO-QOL, PEQ.Main Outcome Measures: Exercise.Results: Data collected from surveys. Responses to WHO-QOL,IPAQ, and PEQ were scored. IPAQ physical activity separated low,medium, high levels. Six of 42 eligible for study; 2 questionnaireswere discarded as incomplete; 4 questionnaires were analyzed, 9%response; mean age, 61.3�6.3 years; all men; type 2 diabetes; allwith postsecondary education, not working. All subjects with tran-stibial amputation, mean age of 58.3�6.3 years. One bilateraltranstibial; 3 “low” physical activity levels, mean MET-min/wk of286�250. One “high” physical activity levels, 2190 MET-min/wk.Quality of life, measured by total WHO-QOL score, increasedlinearly with increase in physical activity levels (positive Pearsoncorrelation of 0.996). Prosthetic-specific quality of life, as measuredby the PEQ, increased linearly with physical activity (positive Pear-son correlation of 0.764). Low response restricted analysis PEQ andWHO-QOL subscales.Conclusions: Higher quality of life, both overall and prosthesisspecific, with higher physical activity levels in lower limb adultamputees. The study may contribute to specific physical activityguidelines. In the community, it could make physical activity moreavailable.

SPINAL CORD INJURY

Poster 427Predictors of Extended Inpatient RehabilitationLength of Stay After Traumatic Spinal Cord Injury.Cara A. Jennings (VCU, Richmond, VA, United States);Juan Carlos Arango, PhD, Castillo Camillo, MD, DavidCifu, Jessica M. Ketchum, PhD, Paola Premuda-Conti,PD, CRC1.

Disclosures: C. A. Jennings, none.Objective: To develop prediction models for identifying thosepatients with traumatic spinal cord injury (SCI) and with paraplegiaor tetraplegia at the time of acute rehabilitation admission who arelikely to have an extended rehabilitation length of stay (RLOS). Themodels will use injury and demographic characteristics.Design: Retrospective database study.Setting: NIDRR SCI Model Systems.Participants: A sample of 2010 patients, between ages 18-70years, with traumatic SCI and who were injured after October 31,2000, and discharged from inpatient rehabilitation before October1, 2009. All the patients included were enrolled in the NationalSpinal Cord Injury Statistical Center database.Interventions: Not applicable.

Main Outcome Measures: Extended RLOS was defined asmore than 89 days for paraplegia and more than 122 days for tetraplegia.Results: For paraplegia, increases in the probability of extendedRLOS were associated with injuries not due to falls or motorvehicles, A or B classifications on the ASIA impairment scale, andhaving spinal surgery. Furthermore, increases in the number of daysfrom injury to rehabilitation admission were associated with anincreased probability of extended RLOS, until about 37 days, andthen with a decreased probability of extended RLOS. For tetraple-gia, increases in the probability of extended RLOS were associatedwith A or B classifications on the ASIA impairment scale, preservedcervical 1-4 neurologic levels, and dependent on mechanical venti-lation. Thresholds in the predicted probabilities were 0.149 (para-plegia) and 0.108 (tetraplegia), however specificities of at least 75%were associated with low sensitivities (53%-58%) (ie, low truepositive rate/high false positive rate).Conclusions: The current predictor model for SCI survivors whorequire extended inpatient rehabilitation may allow for enhancedrehabilitation team planning, improved patient and family educa-tion, and better utilization of health care resources. Cross validationof this model on other populations of individuals with SCI isrecommended.

Poster 429Pulmonary Function in Chronic Cervical SpinalCord Injury: Associations With Level and Durationof Injury.Sarah M. Eickmeyer, MD (RIC, Chicago, IL, UnitedStates); Elliot J. Roth, MD

Disclosures: S. M. Eickmeyer, none.Objective: Investigate associations of level and duration of injurywith pulmonary function in patients with chronic, motor complete,cervical spinal cord injury (SCI).Design: Cross-sectional cohort study.Setting: Outpatient rehabilitation clinic.Participants: Convenience sample of 42 patients (mean age,36�8.5 years; 37 men) with motor complete tetraplegia of trau-matic etiology and at least 5 years’ duration. The patients weredivided into groups by level and duration of injury: “high tetraplegia,”C4 or C5 motor complete (n�24); “low tetraplegia,” C6, C7, C8, or T1motor complete (n�18); “moderate duration,” 5-14 years since injury(n�29); and “long duration,” 15 or greater years since injury (n�13).Interventions: Not applicable.Main Outcome Measures: Pulmonary function tests includedforced vital capacity (FVC), forced expiratory volume in 1 second(FEV1), maximum expiratory pressure, maximum inspiratory pres-sure, inspiratory capacity, expiratory reserve volume (ERV), totallung capacity, and functional residual capacity, and associated age-and gender-predicted percentages of each.Results: Univariate analysis showed that patients with low tetra-plegia had greater FVC, FEV1, ERV, and ERV%- predicted than didpatients with high tetraplegia (P�.05), but there were no differencesbetween patients with high and low tetraplegia for any other pul-monary function tests. Patients with moderate duration had greaterFVC, FVC%-predicted, FEV1, FEV1%-predicted, and inspiratorycapacity than did patients with long duration (P�.05). Multivariateanalysis showed that injury level had significant independent effectson FVC, FVC%-predicted, FEV1, FEV1%-predicted, ERV, andERV%-predicted (P�.05), and that injury duration had significant

S323PM&R Vol. 3, Iss. 10S1, 2011